The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.
Rural–Urban Disparities in Adverse Maternal Outcomes in the United States, 2016–2019
Open accessAbstract
Objectives. To describe differences in maternal admissions to the intensive care unit (ICU) and mortality in rural versus urban areas in the United States. Methods. We performed a nationwide analysis and calculated age-standardized rates and rate ratios (RRs) of maternal ICU admission and mortality per 100 000 live births between 2016 and 2019 in rural versus urban areas. Results. From 2016 to 2019, there was no significant increase in age-standardized rates of maternal ICU admissions in rural (170.6–192.3) or urban (161.7–172.4) areas, with a significantly higher rate, albeit a relatively small difference, in rural versus urban areas (2019 RR = 1.14; 95% confidence interval [CI] = 1.04, 1.20). Maternal mortality increased in both rural (66.9–81.7 deaths per 100 000 live births) and urban (38.1–42.3) areas and was nearly 2 times higher in rural areas (2019 RR = 1.93; 95% CI = 1.71, 2.17). Conclusions. Pregnant individuals in rural areas are at higher risk for ICU admission and mortality than are their urban counterparts. Significant increases in maternal mortality occurred in rural and urban areas. Public Health Implications. Public health efforts need to focus on resource-limited rural areas to mitigate geographic disparities in maternal morbidity and mortality. (Am J Public Health. 2023;113(2): 224–227. https://doi.org/10.2105/AJPH.2022.307134 )
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Martin, S. S., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Barone Gibbs, B., Beaton, A. Z., Boehme, A. K., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001209 · Cited by 2,800
Martin, S. S., Aday, A. W., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Beaton, A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001303 · Cited by 1,284
Palaniappan, L. P., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Currie, M. E., Earlie, R. S., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001412 · Cited by 343
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Ward, Z. J., Atun, R. A., King, G., Dmello, B. S., & Goldie, S. J. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102653 · Cited by 34
Metadata
- Authors
- Harrington, K. A., Cameron, N. A., Culler, K., Grobman, W. A., & Khan, S. S.
- Affiliations
- Northwestern University (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2023-02
- Volume
- 113
- Issue
- 2
- Pages
- 224-227
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC9850610
- OpenAlex
- W4317356890
- Cited by
- 88
- References
- 12
- Citations by year
- 2026: 31 · 2025: 36 · 2024: 18 · 2023: 2
- FWCI
- 32.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (#HL161514, R01HL161514)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- maternal mortality, maternal intensive care unit admission, urban-rural differences, adverse maternal outcomes, maternal morbidity, pregnant people, rural health
- MeSH terms
- Family, Female, Humans, Maternal Mortality, Pregnancy, Rural Population, United States, Urban Population
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